Tracy A. Daniel, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3067 Issued in AZ

Practice address

3200 S Gilbert Rd
Ucextra
Chandler, AZ 85286-5107

Phone

(480) 471-6404

Fax

(480) 219-4915

NPI assigned

Apr 6, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Healthy Design

  • Physician Assistant
  • Chandler, AZ
  • NPI 1205469459
  NPD Authorized official
• No Appointment MD

  • Medical Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1942429923
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1205958386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 S MILL AVE",
            "address_2": "STE 280",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852826850",
            "telephone_number": "480-305-2888",
            "fax_number": "480-305-2889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 S GILBERT RD",
            "address_2": "UCEXTRA",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852865107",
            "telephone_number": "480-471-6404",
            "fax_number": "480-219-4915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "TRACY",
        "middle_name": "A.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "618135",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandon Dang, FNP-BC
• Daniel G. Kline, DDS, PC
• Daniel Link MD PC
• Daniel W Poupard DC
• Renita Daniel
• Alana Daniels
• Andrew Daniels
• David Daniels, MD
• Natasha Alexandra Daniels, LCSW
• Raquel Daniels

• Physician Assistant in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.